Ashly Nicole Bradley, LPC
Individual provider Active NPI Mental Health Counselor · Gladys, VA
NPI 1881275980 · NPPES record last updated Apr 20, 2021
Key facts
- NPI
- 1881275980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 0701010344 (VA)
- Practice address
- 484 Maddox Rd
Gladys, VA 24554-3030 - Phone
- (434) 435-1483
- NPI assigned
- Apr 20, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231214000655 | VA | Practitioner - Mental Health Counselor | 2466801519 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0701010344 | VA | Yes |
Addresses
Primary practice location
484 Maddox Rd
Gladys, VA 24554-3030
Mailing address
1012 Little Bear LN
Spout Spring, VA 24593-3013
Phone (434) 609-0386
Other providers in Gladys, VA
- Phyllis Alexander
- Blessings of Hope Companion Service LLC
- Lucas Dutil
- Harvest Outreach Center
- Harvest Outreach Center, Inc
- Seth Hicks
- Harold Jennings
All providers in Gladys, VA · Mental Health Counselor in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.